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首页> 外文期刊>Current opinion in anaesthesiology >Current aspects of perioperative fluid handling in vascular surgery.
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Current aspects of perioperative fluid handling in vascular surgery.

机译：血管外科围手术期流体处理的当前方面。

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PURPOSE OF REVIEW: Perioperative fluid management influences patient outcome. Vascular surgery unites various surgical procedures, mainly with a high impact on patients who often have relevant preexisting illnesses. There are only scarce data on this specialty, forcing the clinician to extrapolate existing data when planning perioperative fluid management. This review aims to summarize the underlying facts. RECENT FINDINGS: Perioperative insensible perspiration does not exceed 1 ml/kg per hour. A third space shift does not exist; therefore, its primary substitution is erroneous. Rather, a crystalloid fluid excess causes a tremendous shift towards the interstitial space. Colloidal volume effects are context sensitive, that is, only their use as a substitute when blood or plasma loss occurs leads to maintenance within the circulatory space. Colloidal hypervolaemia and surgical trauma both have the potential to deteriorate the vascular barrier, leading to plasma loss into the interstitial space. Current perioperative fluid therapy should aim to maintain normovolaemia of the individual body fluid compartments as far as possible. This might be achieved by combining a protocol-based replacement of extracellular losses (urinary output plus insensible perspiration) with isotonic balanced crystalloids and blood volume optimization using isooncotic colloids. SUMMARY: The basis of fluid therapy in vascular surgery is a careful differential indication of the respective classes of preparations. A goal-directed approach might help to avoid hypovolaemia.
机译：审查目的：围手术期液体管理影响患者预后。血管外科手术将各种外科手术程序结合在一起，主要是对经常患有相关疾病的患者产生重大影响。该专业仅有很少的数据，迫使临床医生在计划围手术期液体管理时推断现有数据。这篇综述旨在总结基本事实。最近发现：围手术期感觉不到的汗水每小时不超过1 ml / kg。不存在第三次空间偏移;因此，它的主要替换是错误的。相反，过量的晶体流体导致向间隙的巨大转变。胶体体积效应是上下文相关的，也就是说，只有在发生血液或血浆流失时才将其用作替代品会导致循环空间内的维持。胶体高容量血症和手术创伤均可能破坏血管屏障，导致血浆损失进入间隙。当前的围手术期液体疗法应旨在尽可能维持各个体液区的正常血容量。这可以通过结合基于协议的等渗平衡晶体替代细胞外损失（尿排泄加排汗障碍）和使用等渗胶体优化血容量来实现。摘要：血管外科手术中液体疗法的基础是对相应类别制剂的仔细区分。目标导向的方法可能有助于避免低血容量。

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